Three ways for physicians to become better advocates

Democrats recently unveiled a campaign to recruit and elect 100 doctors to public office. Democrats hope that by recruiting physicians to public office, they will be able to combat misinformation and restore trust in medicine and science. 

Amid a full-blown measles outbreak, the U.S. plan to withdraw from the World Health Organization, the confirmation of Robert F. Kennedy Jr. to Health and Human Services secretary, the gutting of HHS, and more, the Democrats’ is a worthy goal.

Yet physician groups have been noticeably silent on some of these issues. For instance, the American Medical Association and the American Academy of Pediatrics were largely silent while Robert F. Kennedy Jr. sailed through to confirmation as Health and Human Services secretary. Susan Kressly, president of the AAP, told Roll Call, “We are pediatricians, not politicians,” adding that the AAP generally does not weigh in on specific nominees but provides evidence-based information to senators. “We ultimately need to make partners where we can find them to promote child health,” she said. 

That response falls short of what you might expect from an organization that actively advocates on federal and state child health policy issues. Since Kennedy’s confirmation, the AAP has been scrambling to issue public statements on the importance of families vaccinating their children against measles — but as the parent of an immunosuppressed child and a seasoned patient engagement advocate, it still seems too quiet to me.

In this moment, physicians need to advocate for change both outside and inside their professional organizations. For many, that is difficult. It was even difficult for me at first but I knew it was now my duty. For 22 years, I have navigated my daughter’s health journey in our broken health care system. Along the way, I became an advocate. I offer the patient and caregiver perspective to physicians, health systems, researchers, and policymakers so that we may partner together to make the system more compassionate and equitable. 

So I’d like to share a few pieces of advice, based on my own experiences. I also hope that these recommendations can serve as a foundation for physicians and physician groups to step into their agency.  

1. Foster connection  

That starts with public speaking, which, in this context, is quite different than making a presentation at a conference of your peers or presenting a lecture to your students.

Advocates must be prepared to directly speak to individuals and different types of audiences, in a variety of settings, at any time. Crafting your message and tailoring it to your audience is critically important.

For example, if you are speaking to policymakers (and their staff), avoid medical jargon. Focus on understanding the policy issue from a social and cost perspective, as well as short- and long-term impacts to our nation and/or communities in a particular district or state. Have a community member from their district speaking alongside you. Keep your introductory pitch short — you may not have a great deal of time to convey your message. 

You also have to know who your audience is, including their priorities, their strengths, and their level of influence and power.

Before I attend a meeting, I conduct background research to better understand that person or group, their history with patients and advocates, their mission, and any clues I may be able to find about their organizational culture. If my background research indicates that this person or group is generally supportive of engagement, then I do not need to spend as much time making the case to support my involvement. Instead, I can focus on relationship-building and providing recommendations.

If the opposite is true, then I spend a great deal of time of providing level-setting around patient engagement terminology and promoting the value of engagement through anecdotes and evidence. This all supports crafting my message and understanding how they may view my engagement in their space. 

Do not be afraid to personalize and share your own story. I have always advised physician groups that it is necessary for their members to hear personal stories. You can be confident and vulnerable at the same time.

I am not suggesting you will win everyone’s hearts with personalization. However, when you can break through and perhaps find a connection or a shared commonality through that story, it paves the way to ensure your message is received. Stories are memorable and can propel people to action, particularly if they hear many similar stories from different perspectives.

And remember that this is a long game. You may not always win over a policymaker, but you may win over a staff member who has some influence. 

Don’t be shy. This work starts with writing a letter or calling a policymaker, whether state or federal, to share your concerns for the community and even request a meeting.

2. Create space for compromise

Some of my most vocal opponents have bent slightly when I shared something from the heart. Even a slight bending opens the door for dialogue and mutual understanding. Ultimately this is where compromise may begin and it sets the stage for ongoing communications.

Compromise does not mean abandoning your principles or capitulating to every demand. It requires a careful analysis of what is most important or more urgent in terms of addressing an issue or policy. 

For instance, beginning a dialogue with a local policymaker or a trusted partner in a community who seems unsure about the safety and importance of childhood vaccines is probably a better use of time than utilizing too many resources to ensure a particular meeting on vaccines is held. 

3. Know your North Star

This is where I have witnessed many leaders, health systems, and physician groups lose their way. If you do not know your North Star, you cannot lead effectively, you may be making the wrong decisions, and you will not weather this storm. 

A physician group’s North Star is the doctors it represents and the public they serve. For health systems, the North Star should be employees and patients’ communities. For physicians, the North Star is the patients and families you serve.

I am not naïve to the fact that competing factors like boards, budgets, cost savings, and external pressures can redirect leaders from their North Stars. However, this moment demands flawless clarity of purpose. 

My North Star has always been my daughter and to ensure the patient/public voice is always at the table, front and center. If I lose sight of that, I cannot be an authentic and impactful advocate.

It is quite easy to become accustomed to the status quo, particularly if you have served at a health system or organization in a long-term capacity. A chief nursing officer once shared with me why patient engagement is so important. After purchasing a new home, she told her husband that as soon as they moved in, she would repaint the kitchen, which was an ugly color. Years passed, and she never painted the walls. She forgot she did not like the paint color. Health care organizations need patients and advocates to remind them to paint the walls, she said. Patients don’t just walk past the walls. They can see things that others have grown accustomed to overlooking.  Until someone stops to look at them with a fresh pair of eyes, the walls will not change.

In a politically tumultuous environment, we may face external and internal pressures to not paint the walls, but we must not get comfortable.

Hala Durrah is a nationally recognized patient and family engagement advocate and founder of the Humanization Matters Collaborative.